Being ill is very significant to children. Going to the doctor or staying in hospital are worrying events that need to be discussed at length.
Children need to act out their fears and anxieties in a safe and reassuring way. Playing out the roles themselves, and using cuddly toys and small-world toys, will help children to manage their feelings and understand the feelings of others.
It is helpful too to provide information about what doctors do and why, how hospitals work and how long it takes to get better. Stories are also very important in helping children understand illness.
Adult-led activities
Going to the doctor
Talk to children about their experiences of going to the doctor. If possible, invite a doctor or a nurse to visit the children and show them some of their medical equipment. Talk about why we need to go to the doctor's even when we are not ill, and about ways of staying healthy. Set up a doctor's waiting room and separate surgery.
Key learning intentions
To respond to significant experiences, showing a range of feelings when appropriate.
To interact with others, negotiating plans and activities and taking turns in conversations.
Adult:child ratio 1:up to 6
Resources
For the waiting room: * chairs * magazines * posters about the importance of brushing your teeth, washing your hands, eating healthily, etc * leaflets on health * toys for babies * surgery opening and closing times * list of doctors and nurses on duty
For the receptionist: * appointment book * telephone * telephone book * notices for the doctor saying 'Next' and 'Busy' * alphabet file for records * medical records in envelopes with names on them * alphabet card index file with blank cards * filing cabinet * prescriptions waiting to be collected * map of local area * computer and printer for appointments and for printing out prescriptions * numbered tickets to show which patient is next.
For the doctor or nurse: * patient's bed or couch * roll of plain wallpaper to cover the bed for each patient * weighing machine * height chart * doctors' medical tools such as stethoscope, syringe, thermometer, bandages, slings, crutches, plasters, cardboard bowls, X-rays, model skeleton, models of parts of the body, diagrams or posters of parts of the body, white coat for doctor or nurse.
Activity content
* Talk about the purpose of the waiting room and surgery and the role of the receptionist, nurse and doctor. Take the role of the receptionist and use the resources to make appointments, answer the telephone, take people's names and addresses, and find the medical records for each patient.
* Discuss each resource that you have provided or incorporate it into your role play to make sure that its function is clear. Talk about what the doctor and the nurse do and take turns to play at being the doctor and the patient. Discuss a range of possible illnesses and ways of diagnosing them.
Invite children to contribute their experiences of being ill and getting better.
* Show the children a medical record card with a name on it, and a record of illness with dates. Discuss the purpose of the card. Show them how to store it in the alphabetical index file. Invite them, as the doctor, to make cards for new patients, to write on them and to file them.
* Discuss the appointment book and the times displayed. Talk about how long each appointment might last. Invite them, as the receptionist, to write in new appointments for each new patient.
* Encourage children to answer the telephone and to ask who is calling, what the problem is, and to make an appointment with the doctor. They can talk about days of the week and times of day for the appointments, then write the appointment into the book.
* Show the children the doctor's medical equipment, such as a stethoscope, and discuss the purpose of each. Discuss how, in play, children need to use the equipment carefully when pretending to be a doctor. Talk also about how you know when something is wrong, how you can tell someone about where a pain is, or how sick you feel. Look at the skeleton and the models and diagrams of parts of the body. Talk about the parts of the body, and ask children to identify these parts of the body on themselves. Look at how the different parts of the body move and connect. Sing 'Head, shoulders, knees and toes'.
* Help children measure each other's weight and height, and record these on the medical records.
* Set up a bandage activity, with a variety of different shaped bandages and slings and cuddly toys and dolls. Help children work out ways of wrapping and tying the bandages.
Extending learning
Key vocabulary
Medical records, alphabet, prescription, medicine, appointment, waiting room, surgery, illness, parts of the body, pain, sore, hurt, temperature, injection.
Questions to ask
* How can I help you?
* Can I make an appointment?
* Can you help me find Tania's medical records?
* Patient number two has just gone to see the doctor. Which patient has the next number?
* Which part of your body is painful?n What do we call that part?
* What do you think is wrong with you?
* What do you think will make you feel better?
* How can we put on this bandage?
* How can we comfort this ill patient?
* Doctor, what do I have to do when I go home to get better?
* Why are you waiting to see the doctor?
* How much have you grown since you last came to the doctor?
Follow-up activities
* Discuss different kinds of illness, their symptoms and how to recover from them. Emphasise the getting better aspect of being sick. Story books help in dealing with these issues (see box).
* Make a hospital, with an emergency room and a ward for the cuddly toys.
In the emergency room, have chairs, magazines, forms to complete, appointment book and computer, notices about doctors on duty and a TV. In the ward, have beds with curtains, a little cupboard beside each bed, bedclothes for the patients, 'get well' cards, thermometers, charts and medical notes at the end of the bed, vases of flowers and plastic fruit, a bell to call the nurse, doctor's equipment and so on.
* Read quiet stories to the patient, sing a song, do a jigsaw. Put on a pretend TV show to amuse the patient.
* Talk about going to the dentist. Have X-rays of teeth, posters about brushing teeth, mirrors, false teeth, plaster of Paris teeth. Discuss dental hygiene and why we need to brush our teeth. Children can look at their own teeth in the mirror and count them. Talk about milk teeth and big teeth.
* Set up an optician's surgery. Supply lots of different glasses without lenses, or with plastic lenses, and include sunglasses. Have glasses of different styles and sizes, and mirrors. Have a range of lenses for children to look through that distort things in different ways. Set up an optician's chart with letters in diminishing sizes.
* Turn the vehicles outdoors into ambulances to bring the cuddly toys to hospital.
Fitness testing circuit
Set up a circuit to test children's fitness, as in a gym or in a physiotherapy surgery.
Key learning intentions
Recognise the changes that happen to their bodies when they are active Use developing mathematical ideas and methods to solve practical problems Adult:child ratio 1: up to 3
Resources
* Ramps * stools * cushions * tunnels to crawl through * steps to climb up and down * objects to lift * soft mats * clipboard * easel * paper and pen
Preparation
* Set up a simple circular circuit, with different spots which involve children doing three hops on the blue mat, two jumps on the red mat, going up and down the stairs twice, crawling through the tunnel, climbing up and over and round an obstacle, blowing in the tube, punching the cushion, lift up the heavy object, run along the long mat and so on.
Activity content
* The 'physiotherapist' goes round the circuit with the 'patient' and makes notes on the clipboard of what the patient does.
* There can be an easy circuit and a hard circuit, with a notice at each station on the circuit (such as easy: one jump, hard: two jumps).
* At the end, the patient describes how tired they are and whether their heart is beating faster. They describe how they use their arms to balance along the line, or how they bend their knees to land after a jump.
* They mark their name on the easel (marked 'When you have done the circuit, write your name here') to say that they have done the circuit.
* Discuss with children which parts of their body they use when they do different exercises, and how to move safely. Discuss how when you break your arm or leg, you need physiotherapy to help move properly again.
Extending learning
Key vocabulary
Up, down, round, through, once, twice, over, between, again, balance.
Questions to ask
* How many times can you go up and down the steps?
* Which things on the circuit made you out of breath?
* How can you tell if your heart is beating faster?
* How do you make sure you go through the tunnel without hitting your head?
* How can you land safely after a jump?
Follow up activities
* Children make and keep fitness records and file them in an index file.
* They draw a map of the circuit, showing how many times they did each activity. Next time they go on the circuit, they see if they can beat this record.
* Do the circuit in time to music and stop when the music stops.
Child-initiated learning
Encourage the children to develop their own ideas and interests across the curriculum by adding topic resources to your basic provision.
Small-world play area
Additional resources
* Put out a hospital set with beds, hospital equipment, people, ambulances, stretchers, and so on, in a large space. Start by setting up the whole hospital. Include wards, clinics, accident and emergency department, operating theatre, and so on. Have books and posters on hospitals available nearby.
* Set the ambulances, helicopters and other rescue vehicles up in the outdoor area, with road tracks, bricks and planks, and a box or building for a hospital.
* Provide Duplo and small-world people and hospital equipment for children to build a hospital. Or use a Duplo building as a hospital with different floors, and children equip the hospital from the box.
* Set up a hospital shop with gifts and flowers, and miniature books and newspapers, for the patients.
* Set up a food trolley for taking meals to patients.
* Write menus for the patients so that they can tick their choices.
Possible learning experiences
* Sharing the ambulances and building the hospital together.
* Coping with feelings by acting out being in hospital. Sharing these emotions in play together.
* Learning the language appropriate for hospitals and illness.
* Solving problems in creating a hospital environment, and dealing with any construction problems that may emerge.
The practitioner role
* Plan how to vary the small-world provision to add stimulation and interest.
* Engage in conversations with children to extend their vocabulary, and to help them talk about feelings.
* Help children talk and plan together about who they will be, what parts each will play and what kind of materials they will need.
Creative workshop
Additional resources
* Blank cards and envelopes * assorted ready-made books * paper, pencils, pens * paper, cloth and plastic flowers * plastic fruit and food * gift boxes and baskets * ribbons, wrapping paper and cellophane.
Possible learning experiences
* Make get-well cards for ill people.
* Make posters for the doctor's surgery, the hospital and so on.
* Make a book for an ill person.
* Make a gift to take a hospital patient.
The practitioner role
* Model writing by making greeting cards, books of a visit (such as the nurse) and labels.
* Help children with skills such as tying a ribbon or wrapping a parcel.
Sheila Ebbutt and Carole Skinner are co-ordinators of the Early Childhood Mathematics Group
Books
* Topsy and Tim Go to the Doctor by Jean Adamson (Ladybird, 2.99)
* Topsy and Tim Go to the Hospital by Jean Adamson (Ladybird, 2.99)
* Miffy in Hospital by Dick Bruna (Egmont Books, 3.50)
* Miffy and Others in Hospital by Dick Bruna (Haigh and Hochland, Pounds 3.95)
* Just Awful by Whitney A Marshak (Heinemann, 2.95)
